1984
The State of Punjab, Part II:
Mental Health & Substance Abuse
GUNISHA KAUR
Punjab has been a hotspot of human rights violations and activism since the birth of the Indian nation in 1947. The history of human rights abuses in the state has contributed significantly to the present economic, environmental and medical crisis in Punjab.
In this multi-part series, we explore the emergent issues in the state, with a focus on farmer suicides, female feticide and infanticide, ecological damage, river water rights, rising rates of diseases, mental health, and drug and alcohol abuse.
"The vibrancy of Punjab is virtually a myth … many sell their blood to procure their daily dose of deadly drugs, even beg on the streets for money to continue their addiction … The entire Punjab is in the grip of a drug hurricane which weakens the morale, physique and character of the youth. We are in danger of losing the young generation. The vibrant Punjab that had ushered in the green revolution is today living in a dazed stupor as 67 percent of its rural households has at least one drug addict." (Harjit Singh, Dept of Social Security and Women & Child Development)
The recent history of human rights violations in Punjab has contributed significantly to the current health crisis in the region. Genocidal actions by the federal and state governments have directly led to alarming levels of psychiatric disorders and drug abuse.
These actions include human rights violations during Operations Bluestar and Woodrose, the 1984 pogroms, and the violent counter-insurgency campaign in Punjab.
Though the government’s campaign was largely complete by the mid 1990s with the elimination of human rights activists such as Jaswant Singh Khalra, the physical and psychological effects of the violence have lasted decades longer. The government’s abuse of Sikhs remains one of the darkest chapters in Indian history and has been a foundation to the psychiatric and substance abuse problems in the state.
A study by Physicians for Human Rights (PHR) and the New York University (NYU) School of Medicine's Bellevue Program for Survivors of Torture investigated the violence in Punjab through documenting victims’ experiences.
The study found that among those interviewed, 75% of people who survived torture by the Punjab Police suffer from past or present Post Traumatic Stress Disorder (PTSD) and 53% suffer from past or present Major Depressive Disorder (MDD).
Like any other medical condition, PTSD and MDD are diagnosed by specific criteria and prescribed treatments are available for each.
Despite the availability of these treatments and medically recognized pathophysiology in the West, significant psychiatric conditions such as these typically remain neglected in India.
For instance, the ratio of psychiatrists to patients in India is 1 to 314,000, a value significantly lower than the ratio of 1 to 6000 in developed nations such as the United States. This ratio points to the lack of recognition and attention to mental health issues in India.
This neglect proves particularly dangerous in the post-genocide Punjabi context in which psychological trauma plays a significant role in the continued disability of individuals and families.
Medical literature has demonstrated that psychiatric illnesses such as MDD and PTSD serve as major precipitants for alcohol and drug abuse. Though these disorders are not the only reason for substance abuse in the state (e.g., government profits incurred through excise tax on alcohol sales), the past two decades have observed an exponential rise in alcohol and drug use in Punjab.
Current reports cite up to 70% and 56% drug and alcohol addiction in rural and urban areas, respectively.
While no rigorous statistical analysis has been published on the scale of drug abuse in Punjab, newspapers and journals have recently documented stories indicating the increasing severity and urgency of the situation. For example, BBC news reported on a recent study by Guru Nanak Dev University, which suggests that nearly 70% of Punjabi youth are addicted to drugs or alcohol.
A survey conducted by the Indian Department of Social Security and Women and Child Development reveals that 67% of rural households in the state have at least one drug addict. In fact, approximately one-fifth of the total heroin seizures in India and approximately 60% of all illicit drugs seizures in India come from Punjab.
These figures are particularly striking when one considers that the state of Punjab constitutes only 2.4% of the Indian population.
In 2005, a Sikh-Indian writer and filmmaker, Reema Anand, published an article in the Tribune on the issue of drug addiction in the region. She writes:
"After touring the state for three days and three nights, I realize my state, which was once an epitome of prosperity, joy and laughter, basant and mustard fields, is slowly sinking into an unmentionable physical and mental despair. I stare into a new future, where Punjabis (70 per cent) will be mere zombies and hence soft target for any form of exploitation by the State, vested foreign interest and mercenary individuals. It is a ticking time bomb."
The protection of fundamental human rights has been a constant struggle in the recently created Indian nation. In the wake of the federal and state government's human rights suppression in the 1980s and 1990s, PTSD and MDD continue to plague the psychological health of Punjabis and compound the unprecedented rates of drug and alcohol abuse.
The situation in Punjab demands serious attention.
The issues of psychological illness and drug dependence are interlinked with the multitude of problems ravaging the state. The current situation requires a biopsychosocial model of rehabilitation, which addresses the biological, psychological, and social factors underlying the issues.
Potential solutions will be discussed in the final article of this series.
The author is a human rights activist and a physician at Cornell University in New York City. Her research focuses on chronic pain management in survivors of torture, and she has written extensively on human rights violations in India. Her first book, entitled "Lost in History: 1984 Reconstructed" - [http://www.panjabmall.com/storeproduct508.aspx], documents the violence in Punjab that took place in the 1980s and 1990s. The articles in this series draw from her forthcoming book, which discusses the current economic, environmental, and health crisis in Punjab.
To re-visit Part I, please CLICK here.
May 14, 2012
Conversation about this article
1: Baldev Singh (Bradford, United Kingdom), May 15, 2012, 5:34 PM.
1) Where are the parents in Punjab? 2) Where are the granthis - who don't drink! - in Punjab? And finally ... 3) Where are the teachers in Punjab? What are these groups up to?